Volume 9, Issue 3, March – 2024
ISSN No:-2456-2165
A Study was Conducted to Evaluate the Risk Factors
Associated with Stroke among Hypertensive Patients
Receiving Care at the Medical Outpatient Department
(OPD) of HSK Hospital & Research Centre in
Navanagar, Bagalkot.
1.
Yallappa Mali
Community Health Officer
Gersoppa HWC
Honnavara. Uttarkannada
3.
Dr. Dileep Natekar
Principal
BVVS, Sajjalashree Institute of Nursing Sciences. Bagalkote.
5.
Devendra Gavari
Assistant Professor Dept of Paediatric Nursing
BES, Bagalkot College of Nursing BAGALKOT
Abstract:- BACKGROUND OF THE STUDY:*
Hypertension, characterized by elevated blood pressure, is
a major public health concern globally. It is a leading
cause of cardiovascular diseases, including stroke. Stroke,
a neurological condition, is a significant cause of mortality
and disability, especially in low- and middle-income
countries. Hypertension is a predominant risk factor for
stroke both globally and in our country. Hence, there is a
critical need to enhance stroke education, particularly
targeting low-income individuals at high risk, through
public health campaigns and targeted health education
efforts. OBJECTIVES OF THE STUDY: 1. To assess the
knowledge of hypertensive patients regarding stroke risk
factors and prevention. 2. To determine the association
between knowledge scores and selected socio-demographic
variables. HYPOTHESIS: H1: There will be a significant
association between the knowledge level of hypertensive
patients and their socio-demographic variables.
CONCEPTUAL FRAMEWORK: This study adopts the
health belief model proposed by Becker as its conceptual
framework. METHODOLOGY: The research employed a
descriptive survey design to assess stroke risk factors
among hypertensive patients attending the medical OPD of
HSK Hospital & Research Centre in Bagalkot. Non-
probability convenient sampling was used to select 100
hypertensive patients for the study. Data collection utilized
a structured questionnaire consisting of two sections:
IJISRT24MAR025 www.ijisrt.com
International Journal of Innovative Science and Research Technology
https://doi.org/10.38124/ijisrt/IJISRT24MAR025
2.
Varesh Chilapur
Associate Professor and HOD of MSN Dept
SIONS College Navanagar Bagalkote
4.
Raghavendra Holdur
Nursing Officer MCH Ilkal,
Section I focused on socio-demographic variables, while
Section II assessed stroke risk factors. RESULTS: The
study revealed that hypertensive patients exhibited varying
levels of knowledge regarding stroke risk factors. On
average, the overall knowledge score was 55.3%. The
percentage distribution of hypertensive patients based on
their knowledge level showed that 24% had poor
knowledge, 50% had average knowledge, and 26% had
good knowledge. CONCLUSION: The study identified a
significant association between the knowledge level of
hypertensive patients and certain socio-demographic
characteristics, particularly the source of information.
However, no significant associations were found with other
variables such as age, gender, education, occupation, and
health history. This underscores the importance of
targeted health education interventions aimed at
improving awareness of stroke risk factors among
hypertensive patients.
Keywords:- Hospital, Hypertensive Patients, Knowledge,
Outpatient Department, Risk Factors of Stroke, Study.
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Volume 9, Issue 3, March – 2024
ISSN No:-2456-2165
I. INTRODUCTION
Hypertension, also known as high blood pressure, is a
chronic cardiac medical condition characterized by elevated
systemic arterial blood pressure. This condition necessitates
increased effort from the heart to pump blood throughout the
body.1 Blood pressure is typically measured using two values:
systolic and diastolic. A normal blood pressure reading is
120/80 mmHg. Hypertension is broadly classified into primary
(essential) hypertension and secondary hypertension, with
approximately 90–95% of cases falling under the former
category. Primary hypertension can be influenced by medical
conditions and lifestyle factors, 2 while secondary
hypertension, accounting for the remaining 5–10% of cases, is
caused by other systemic conditions. 3
Hypertension tends to be more prevalent in men
compared to women until the age of 45, after which the
percentages of men and women with high blood pressure
become similar. Women may have a higher risk of developing
hypertension after the age of 55, particularly following
menopause when estrogen's protective effects decline.
There is a clear association between family history and
hypertension, with individuals having a parent, sibling, or
grandparent with hypertension being at higher risk. Lifestyle
habits such as weight gain, 4 lack of regular physical activity,
and chronic, heavy alcohol use are also linked to hypertension.
Certain illegal recreational drugs like cocaine, heroin, and
methamphetamine can cause sudden spikes in blood pressure,
leading to hypertensive emergencies.5
A stroke, often referred to as a "brain attack," occurs
when blood flow to a specific area of the brain is interrupted,
leading to the death of brain cells.6 Uncontrolled high blood
pressure can contribute to stroke by damaging and weakening
the brain's blood vessels, leading to narrowing, rupture, or
leakage. It can also promote the formation of blood clots in the
arteries supplying the brain, potentially resulting in a stroke. 7
Strokes can be caused by either blocked arteries
(ischemic stroke) or the leaking or bursting of blood vessels
(hemorrhagic stroke). Some individuals may experience
temporary disruptions in blood flow to the brain, known as
transient ischemic attacks (TIAs),8 which do not result in
permanent damage.
According to estimates from the World Health
Organization (WHO), stroke accounted for a significant
number of deaths and first-time events in 2005, with
projections indicating a potential increase in these numbers by
2030. Stroke ranks as the second leading cause of preventable
death globally and the fourth leading cause of lost
productivity,9 as measured by disability-adjusted life years.
Epidemiological studies have shown that the risk factors for
stroke and their associations are consistent across different
regions worldwide.10
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International Journal of Innovative Science and Research Technology
https://doi.org/10.38124/ijisrt/IJISRT24MAR025
II. MATERIAL AND METHOD
In this study, a cross-sectional design was employed to
evaluate the risk factors of stroke among hypertensive clients
attending the medical OPD of HSK Hospital and Research
Centre in Bagalkot, Karnataka. A non-probability convenient
sampling technique was utilized to select 100 hypertensive
clients attending the medical OPD. Data collection involved
the use of an interview schedule with a questionnaire
comprising 11 items related to socio-demographic
information, including age, gender, educational status,
occupation, duration of illness, personal habits, type of diet,
previous history of stroke, family income, family history of
stroke, and source of information. Additionally, Part II of the
questionnaire consisted of 36 closed-ended multiple-choice
questions concerning the risk factors of stroke. Each correct
answer was assigned a score of one, while a wrong answer
received a score of zero, resulting in a total score of 47. A
pilot study was conducted to assess the feasibility of the study,
and the reliability and validity of the tool were ensured
through pre-test methods and consultation with experts. The
variables studied included research variables related to the risk
factors of stroke and extraneous variables such as age, gender,
educational status, occupation, duration of illness, personal
habits, type of diet, previous history of stroke, family income,
family history of stroke, and source of information.
Data collection took place from February 26, 2020, to
March 6, 2020, at the Medical OPD of HSK Hospital and
Research Centre Bagalkot, after obtaining permission from the
Dean. Ethical clearance was obtained, and consent was
obtained from the participants. During data collection, the
researcher introduced the study to the participants, explained
the procedures, and collected data using the interview
schedule with the stroke risk factors questionnaire. Data
collection occurred with 10-12 hypertensive clients per day,
with each participant taking approximately 15-20 minutes to
complete the questionnaire.
For data analysis, descriptive and inferential statistics
were employed, including frequency and percentage
distribution, mean, mean percentage, standard deviation, chi-
square test, Fisher’s exact probability test, and linear
regression analysis. These analyses aimed to explore the
association between the risk factors of stroke among
hypertensive clients and their selected socio-demographic
variables.
Regarding ethical considerations, permission was
obtained from the Principal of Shri B.V.V. Sangha’s
Sajjalashree Institute of Nursing Sciences, Bagalkot, and the
Dean of H.S.K. Hospital and Research Centre, Bagalkot.
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Volume 9, Issue 3, March – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24MAR025

III. RESULT history of stroke, and according to their Source of

 Section I: Description of socio-demographic characteristics
of sample. Percentage wise distribution of hypertensive
clients attending in medical OPD according to their age
groups reveals that out of 100 subjects, higher percentage
(40%) of hypertensive clients were in the age group of 61
years and above, were (60%) of hypertensive clients are
females, (32%) of hypertensive clients have studied
secondary education, (36%) of subjects are private
employee, (51%) of hypertensive clients have health
illness of 9 days, According to their habits it reveals that
(48%) of hypertensive clients are not having any bad habit,
were(64%) of hypertensive clients are non-vegetarians,
(76%) of hypertensive clients not have previous history of
stroke, (32%) of hypertensive clients have Rs. 15001-
20000,were (60%) of hypertensive clients not have family
information revels out of 100 subjects highest percentage
(48%) of hypertensive clients have got information from
television.
Table 1 shows the Hypertensive patients domain wise
percentage of knowledge on risk factors of stroke. They are
having 61% of knowledge on “meaning and concept of
stroke”, 52.8% of knowledge on “causes and risk factors of
stroke management of Hypertension”, 55.3% on “sign and
symptoms of stroke”, 58% on “diagnosis of stroke”, 49% on
“management of stroke”, and they have maximum knowledge
in “meaning and concept of stroke” (61%). On an average
overall knowledge score on risk factors of stoke among
hypertensive clients is 55.3% and mean score of 19.92, SD -
0.7210.

Table 1: Area Wise Percentage of Knowledge of Hypertensive Clients Regarding Risk Factors of Stroke. N=100
Knowledge Area Number of Min-Max Score Knowledge score % of Mean Score
Questions Mean Score SD Score
Meaning &concept of 10 0-10 6.1 0.25 61%
stroke
Causes & risk factors 10 0-10 5.2 0.24 52.8%
of stroke
Sign & symptoms of 06 0-6 3.3 0.13 55.3%
stroke
Diagnosis of stroke 03 0-3 1.7 0.017 58%
Management of stroke 07 0-7 3.8 0.14 49%
TOTAL 36 0-36 19.9 0.72 55.3%

Table 2 shows the Percentage wise distribution hypertensive clients based on their level of knowledge regarding risk factors of
stroke.24% of hypertensive clients having poor knowledge and 50% of the hypertensive clients having average knowledge, 26% of
hypertensive clients having good knowledge.

Table 2: Level of Knowledge of Hypertensive Clients Regarding Risk Factors of Stroke. N=100
Level of Knowledge Frequency of Hypertensive Patients Percentage%
Poor 24 24%
Average 50 50 %
Good 26 26%
Total 100 100%

Table 3: It reveals that association between knowledge of hypertensive clients with socio- demographic characteristics. Findings
suggest that H1. There is significant association found between level knowledge with socio-demographic characteristics like source of
information [x2=8.32, p<0.05], more than table value, accepted. And no significant association found between the other variables, age,
gender, education, and occupation, duration of health issue, diet pattern, and previous history of stroke. Monthly income, personal
habits, family history of stroke.

Table: 3 Association between Knowledge of Hypertensive Clients Regarding Risk Factors of Stroke with their Socio
Demographic Characteristics.
SI NO Variables Chi-Square Value (X2) DF Table Value Significance
1 Age 0.15 3 7.81 Not significant
2 Gender 0.66 1 3.86 Not significant
3 Educational status 4.93 3 7.81 Not significant
4 Occupation 5.7 3 7.81 Not significant
5 Duration of health illness 2.99 3 7.81 Not significant

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Volume 9, Issue 3, March – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24MAR025

6 Personal Habits 3.13 3 7.81 Not significant

7 Type of diet pattern 0.69 1 3.86 Not significant
8 Previous history of 3.50 1 3.86 Not significant
9 Stroke
Monthly income of 4.94 3 7.81 Not significant
10 Familyof Stroke
Family history 0.66 1 3.86 Not significant
11 Source of information 8.32 3 7.81 Significant

IV. Family
DISCUSSION REFERENCES

Analysis and interpretation of data collected from 100
hypertensive clients at the medical Outpatient Department
(OPD) of H.S.K. Hospital and Research Centre, Navanagar,
Bagalkot were conducted using descriptive and inferential
statistics. The data were tabulated, analyzed, and interpreted to
answer the research questions. The purpose of the analysis was
to reduce the data into an intelligible and interpretable form to
study the relationship of research problems. The percentage of
hypertensive clients based on their level of knowledge
regarding risk factors of stroke revealed that 24% had poor
knowledge, 50% had average knowledge, and 26% had good
knowledge. These findings are supported by a study
conducted on the knowledge of stroke risk factors among
primary care Korean hypertensive patients visiting tertiary
hospitals, which found a similar probability of stroke among
hypertensive patients. Another cross-sectional study assessed
knowledge of stroke risk factors among individuals diagnosed
with hypertension and/or diabetes, revealing that although a
majority knew at least one risk factor, specific risk factors
were poorly understood. This study is limited to assessing risk
factors of stroke among hypertensive patients at the medical
OPD of HSK Hospital Bagalkot.
V. CONCLUSION
Chi-square tests were computed to determine the
association of knowledge with selected demographic
variables. The results revealed a significant association
between the level of knowledge and socio-demographic
characteristics such as the source of information (x2= 8.32,
p<0.05). No significant association was found between other
variables including age, gender, education, occupation,
duration of health issues, diet pattern, previous history of
stroke, monthly income, personal habits, and family history of
stroke.
ACKNOWLEDGMENTS
We express our sincere gratitude to everyone for their
valuable guidance and support.
[1]. Tafseer.A study to assess the effectiveness of structured
teaching programme on home care management of
hypertension among hypertensive patients in selected
urban areas, at bangalore.2011.
[2]. What is High Blood Pressure? Where does it come from?
What are the effects? How do you get rid of it?. Yahoo
answers. Available from
theURL:https://answers.yahoo.com/question/index;
ylt=hFY.
[3]. StibichM. Causes and Risk Factors of Hypertension.
Medicallyre view edbyaboard-certified physician. 2018
AUG.
[4]. Kearney PM, Whelton M, Reynolds K, Worldwide
prevalence of hypertension: A systematic review. J
Hypertens. 2018 AUG.
[5]. Reddy KS. Hypertension control: National stroke
association. Available from the URL:
https://www.stroke.org/understand-stroke/what-is-
stroke/.
[6]. What is stroke? National stroke association. Available
from the URL: https://www.stroke.org/understand-
stroke/what-is-stroke/.
[7]. High blood pressure dangers: Hypertension's effects on
your body. By Mayo
ClinicStaff.AvailablefromtheURL:https://www.mayoclin
ic.org/diseases-conditions/high-blood-pressure/in-
depth/high-blood-pressure/art-20045868.
[8]. Pickering TG, James GD, Boddie C, Harshfield GA,
Blank S, Laragh JH. How common is white coat
hypertension? JAMA.1988;259:255–8.[PubMed][
GoogleScholar]
[9]. Stroke.Mayoclinic.AvailablefromtheURL:https://www.m
ayoclinic.org/diseases-conditions/stroke/symptoms-
causes/syc-20350113.
[10]. Kuklina E, Tong X,George M, Bansil P. Epidemiology
and prevention of stroke: a worldwide perspective.
Author manuscript. 2012 Feb; 12(2): 199–208.
[11]. Singh S, Shankar R,Singh G P. Prevalence and
Associated Risk Factors of Hypertension:ACross-
SectionalStudyinUrbanVaranasi.IntJHypertens.2017Dec.
[12]. StrokeStatistics.Anindependentwebresourceforinformatio
naboutstrokecareand research. 1 March 2019.

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